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The most frequent allergic reactions are type I reactions, which take place primarily on epithelial surfaces (skin, lungs, gastro-intestinal tract) and are characterized by the formation of specific immunoglobulin E against the allergens. These type I reactions are referred to as instant reactions and are the classic causes of allergic rhinitis, asthma and atopic dermatitis. The occurrence of this allergy type involves TH2 lymphocytes, which cause B lymphocytes to produce specific IgE antibodies, which are then bound to the surface of mast cells. On repeated contact with this allergen and cross-linking of at least 2 mast cell-bound IgE antibodies, the mast cell secretes the biogenic amine histamine, which causes the symptoms of the allergy.

Type II and III allergies are characterized by the formation of immunoglobulin G or M, with type II reactions acting against cell surfaces and type III reactions against soluble antigens. In type III reactions, the IgG antibodies form immunocomplexes with the allergens, which can cause exogenic allergic alveolitis, for example. Furthermore, IgG antibodies against food stuff are suspect to mediate delayed food allergies.

Type IV and V allergies

Type IV reactions are cellular reactions which predominantly involve T lymphocytes. The granulomatous type V allergy can be regarded as a variant of type IV allergy, as it also triggers a cell-mediated immune reaction, but involves macrophages instead of T lymphocytes.

Allergy diagnostics

As a rule, the allergens are proteins from natural sources such as pollens, animal epithelia, insect venoms, foodstuffs, mites etc., although medicines such as penicillin and its derivatives can also trigger type I allergies. Patients show often a wide range of varying symptoms and sensitization patterns against several allergens. It is necessary to test a patient’s blood whenever an allergic response or severe reaction is suspected. The allergy diagnostics of R-Biopharm AG offers two quantitative test methods for the antibody detection, the enzyme immunoassay (RIDASCREEN® Allergy ELISA) and the immunoblot (RIDA qLine® Allergy).